Healthcare Provider Details

I. General information

NPI: 1346077666
Provider Name (Legal Business Name): MINOO VAFAI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2024
Last Update Date: 10/29/2025
Certification Date: 10/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 CHURCH ST NW
HUNTSVILLE AL
35801-5573
US

IV. Provider business mailing address

PO BOX 2409
HUNTSVILLE AL
35804-2409
US

V. Phone/Fax

Practice location:
  • Phone: 256-536-4700
  • Fax: 256-436-4117
Mailing address:
  • Phone: 256-536-4700
  • Fax: 256-436-4117

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number4741C
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: